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[Application Value of Neoadjuvant Targeted Therapy in Patients with EGFR-mutant Resectable Lung Adenocarcinoma]
Shijie Huang1, Mengying Fan2, Kaiming Peng3
1Department I of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian 351100, China.
Background:
The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma.
Methods:
A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024.
Results:
A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%.
Conclusions:
The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.
Insights
Neoadjuvant targeted therapy shows promise for Chinese patients with EGFR-mutant lung cancer, offering high response rates and good survival outcomes with manageable side effects.
Area of Science:
- Oncology
- Thoracic Surgery
- Molecular Targeted Therapy
Background:
- Non-small cell lung cancer (NSCLC) with EGFR mutations is prevalent in China.
- Current neoadjuvant treatments offer limited benefits for these patients.
- Investigating neoadjuvant targeted therapy's efficacy and safety is crucial.
Purpose of the Study:
- To evaluate the efficacy and safety of neoadjuvant targeted therapy.
- To explore its application value in EGFR-mutant resectable lung adenocarcinoma.
- To identify potential benefits for Chinese NSCLC patients.
Main Methods:
- Multicenter retrospective study.
- Inclusion of patients with Stage IIA-IIIB EGFR-mutant lung adenocarcinoma.
- Analysis of surgical resection outcomes post-neoadjuvant targeted therapy.
Main Results:
- High R0 resection rate (100.0%) achieved in 24 patients.
- Objective response rate (ORR) of 83.3% and major pathologic response (MPR) rate of 37.5%.
- Favorable safety profile with grade 1-2 adverse events (54.2%) and 100% overall survival at 33 months median follow-up.
Conclusions:
- Neoadjuvant targeted therapy is safe and feasible for EGFR-mutant lung adenocarcinoma.
- It presents a promising treatment option for resectable cases.
- Potential to improve outcomes for patients with EGFR-mutant lung adenocarcinoma.
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